Field evaluation of the ICT Malaria P.f./P.v. immunochromatographic test in India

In India the only antigen-capture assays available for routine malaria diagnosis are designed to detect P. falciparum (Singh et al. 1997; Valecha et al. 1998) although most cases of malaria (60%) are caused by P. vivax (Sharma 1999). The aim of the present Indian study was to evaluate a commercial dipstick-based assay that is designed to detect P. vivax as well as P. falciparum and probably P. malariae and P. ovale. The assay investigated is known as the ICT Malaria P.f./P.v.(TM) immunochromatographic test (ICT; AMRAD- ICT Bookvale Australia). This test is based on the detection of histidine-rich protein 2 (HRP2) from P. falciparum and a genus-specific pan-malarial antigen that appears to be present in all four of the Plasmodium species that can cause human malaria (Tjitra et al. 1999; Mason et al. 2001). The present investigation which was approved by the ethical committee of the Malaria Research Centre in Delhi formed part of a multicentre study of an epidemic tribal area of Madhya Pradesh in central Indian (Singh et al. 2000). The present data were generated during surveys in the urban areas of Delhi in northern India and Chennai in the south in September-October 1999. Delhi is an area with relatively low levels of malaria transmission sporadic transmission occurring from the end of April into May and again from the onset of the monsoon in July to October (Adak et al. 1998). The incidence of malaria in Chennai is much greater cases of malaria in the city representing 50%-70% of all those occurring in the state of Tamil Nadu (Dua et al. 1997). Chennai has fairly stable perennial transmission although there are peaks in July-August and October-November. In both Delhi and Chennai those who presented at malaria clinics with the typical signs and symptoms of malaria and those who were found to be febrile during active case-detection surveys in suburban area were enrolled. (excerpt)